On Aug. 28, Foreign Policy magazine released an exclusive story by Harald Doornbos and Jenan Moussa titled Found: The Islamic State's Terror Laptop of Doom. The story noted that among a cache of documents found on a computer captured from the Islamic State in Syria was a 19-page document purported to be instructions for creating a biological weapon by weaponizing plague extracted from infected animals. According to the article, the document noted: "The advantage of biological weapons is that they do not cost a lot of money, while the human casualties can be huge."

This document provides a good example of the terrorist tradecraft conundrum militant organizations often face, in which their intent outstrips their capability. While biological weapons do appear to be easy to manufacture and deploy in theory, history shows a successful biological weapons program is far harder to achieve than it may appear at first glance.

As we noted in 2009 in response to rumors that al Qaeda in the Islamic Maghreb was experimenting with the plague as well, the plague, sometimes referred to as the Black Death, is a naturally occurring disease that is caused by the bacterium Yersinia pestis. This pathogen is found in rodents and fleas that infest them and exists in many parts of the world, including the western United States. According to the U.S. Centers for Disease Control and Prevention, there are some 1,000 to 2,000 cases of plague diagnosed in humans every year, with between one and 17 of those cases occurring in the United States. It is notable, however, that according to the World Health Organization, plague does not occur naturally in Syria or Iraq, although it does in Libya and Algeria.

Y. pestis can infect humans in three ways. The bacteria cause pneumonic plague when inhaled, though pneumonic plague can also occur when plague bacteria from another form of transmission infect the lungs. Bubonic plague results when the bacteria enter through a break in the skin (such as a fleabite) and septicemic plague occurs when the bacteria multiply in the victim's blood, usually after being infected by one of the other types. In general, a fleabite is the primary form of infection, and if the infection is left untreated, it can evolve into a case of bubonic (the most common outcome) or septicemic plague.

Y. pestis is a fragile bacterium that does not last long in sunlight or after it is dried, and plague is treatable with antibiotics, which are especially effective if administered early. However, pneumonic plague can be contagious if a person inhales respiratory droplets containing the bacteria from an infected person. Such a transmission usually requires close contact with the infected individual. Merely wearing a simple surgical mask can protect a person from pneumonic plague infection.Weaponized Plague

Before we assess the Islamic State's capability and intent to create a weapon using plague, let's first look briefly at the history of plague as a weapon.

Plague has long been of interest as a weapon in biological warfare, with reports from Tatars catapulting plague-infected bodies at Genoese sailors in the City of Caffa in the Crimea in the 14th century, to Japan's efforts to drop clay pots of plague-infected fleas over Manchuria, to the Soviet weapons programs during the Cold War and perhaps beyond. While the Tatars and Japanese used the bubonic form of the plague, according to former Soviet scientist Ken Alibek, the Soviet program focused on and perfected an aerosolized form of the bacterium designed to cause pneumonic plague.

Without question, the best example of a modern non-state actor developing a biological weapons program was the Japanese Aum Shinrikyo, which in the late 1980s assembled a team of trained scientists and spent millions of dollars to develop a series of state-of-the-art biological weapons research and production laboratories.

Aum experimented with botulinum toxin, anthrax, cholera and Q fever and even tried to acquire the Ebola virus. However, despite multiple attempts to produce mass casualty attacks using botulinum toxin and anthrax from 1990 to 1993, Aum was not able to produce a virulent agent -- indeed, nobody outside of the group was even aware that the attacks happened. It was only when the group switched to producing chemical weapons, such as the nerve agent sarin and sodium cyanide gas, that it was able to conduct fatal attacks in 1995. The investigation into the chemical attacks produced the evidence of the group's extensive biological weapons program. Frankly, they could have killed far more people, with far less expense and effort, using firearms or bombs, but such conventional weapons could never produce the global apocalypse the group's leadership aspired to.

Despite the difficulties inherent in developing a biological weapons program, radical groups have not given up. It has long been known that jihadist groups such as al Qaeda have sought to develop chemical and biological weapons, believing that using such weapons is not only permissible but even an obligation. In an interview aired on ABC News in December 1998, Osama bin Laden said, "If I have indeed acquired these weapons, then this is an obligation I carried out, and I thank God for enabling me to do so." While terrorist groups have experimented with crude biological toxins such as ricin and crude chemical compounds such as sodium cyanide gas, they have not been able to parlay those experiments into viable weapons capable of creating mass casualties.Radical Intent

To properly understand the threat posed by the Islamic State's employing biological weapons, we must examine both the group's intent and capability. First, as noted above, the group has ample ideological justifications. Second, by design, terrorist attacks are intended to have a psychological impact far outweighing the physical damage they cause. As their name suggests, they are meant to cause terror that amplifies the actual attack. The Islamic State has a long history of conducting brutal actions intended to cause panic, and a successful biological terrorist attack would certainly create such a panic.

Clearly, if the Islamic State were able to develop effective biological weapons, it would employ them, if not against targets in the West, then against regime targets in Iraq and Syria. Indeed, in 2006 and 2007 the group's predecessor, al Qaeda in Iraq, included large quantities of chlorine in vehicle bombs in an effort to cause mass casualties against U.S. and Iraqi troops in Iraq. These weapons proved quite ineffective, and the explosives in the bombs killed more people than the chlorine. This caused the group to discontinue their use when they did not achieve the desired results.

The Islamic State would love to discover a cheap and easy way to create mass casualties, but in pursuing plague as a weapon, the group appears to have bought into some of the many common misconceptions involving biological weapons, namely, that they are easy to obtain, easy to deploy effectively, and, when used, always cause massive casualties. But as illustrated by the above-mentioned Aum Shinrikyo example, in the real world, creating an effective biological weapons program requires extensive investment, scientific know-how, and time and effort -- and they still don't always work as advertised.Limited Capability

Like many biological agents, there are great challenges associated with producing and employing large quantities of a virulent biological agent. Certainly, plague can be obtained from the environment in a place where it occurs naturally, such as Algeria or Libya, but taking that bacteria and producing a large quantity of it in a virulent form and then disbursing it in an efficient manner is another matter entirely. While the huge Soviet biological weapons program was able to overcome these obstacles and successfully produce an effective aerosolized plague weapon, it would be difficult for a smaller organization like the Islamic State to do so, especially since it lacks access to a large and advanced biological weapons program and the associated and necessary facilities.

In addition to the difficulty of establishing a viable biological weapons program in the Islamic State-controlled areas of Iraq and Syria, there are also some additional problems with the plot as reportedly outlined in the purported Islamic State biological warfare document. According to Foreign Policy, the document advised the attackers to "use small grenades with the virus, and throw them in closed areas like metros, soccer stadiums, or entertainment centers," and said that it is "best to do it next to the air-conditioning. It also can be used during suicide operations."

As noted above, Y. pestis is a fragile bacterium. The heat and shock of a grenade explosion would almost certainly kill most of the bacteria before it could be transmitted to a victim. Even if some of the bacteria were to survive the grenade's explosion, bubonic and septicemic plagues are not easily spread from person to person, and an attack with a small grenade device would therefore be unlikely to cause an epidemic; it would likely cause more panic than deaths.

If Islamic State attack planners could isolate a virulent strain of Y. pestis, infecting a few suicide operatives with pneumonic plague and then dispatching them to cough and sneeze on people, or attempting to release some infected fleas in a targeted area, might better serve them. But even if the group were somehow successful in infecting people, even these scenarios would not produce the type of mass casualties the Islamic State seeks since plague is readily treatable with antibiotics, making weaponized plague just another jihadist pipe dream.

The deadly Ebola outbreak sweeping across three countries in West Africa is likely to last 12 to 18 months more, much longer than anticipated, and could infect hundreds of thousands of people before it is brought under control, say scientists mapping its spread for the federal government.

Both the time the model says it will take to control the epidemic and the number of cases it forecasts far exceed estimates by the World Health Organization, which said last month that it hoped to control the outbreak within nine months and predicted 20,000 total cases by that time. The organization is sticking by its estimates, a W.H.O. spokesman said Friday.

But researchers at various universities say that at the virus’s present rate of growth, there could easily be close to 20,000 cases in one month, not in nine. Some of the United States’ leading epidemiologists, with long experience in tracking diseases such as influenza, have been creating computer models of the Ebola epidemic at the request of the National Institutes of Health and the Defense Department.

The Centers for Disease Control and Prevention declined to comment on the projections. A spokesman, Tom Skinner, said the agency was doing its own modeling and hoped to publish the results soon. But the C.D.C. director, Dr. Thomas R. Frieden, has warned repeatedly that the epidemic is worsening, and on Sept. 2 described it as “spiraling out of control.”

While previous outbreaks have been largely confined to rural areas, the current epidemic, the largest ever, has reached densely populated, impoverished cities — including Monrovia, the capital of Liberia — gravely complicating efforts to control the spread of the disease. Alessandro Vespignani, a professor of computational sciences at Northeastern University who has been involved in the computer modeling of Ebola’s spread, said that if the case count reaches hundreds of thousands, “there will be little we can do.”

What worries public health officials most is that the epidemic has begun to grow exponentially in Liberia. In the most recent week reported, Liberia had nearly 400 new cases, almost double the number reported the week before. Another grave concern, the W.H.O. said, is “evidence of substantial underreporting of cases and deaths.” The organization reported on Friday that the number of Ebola cases as of Sept. 7 was 4,366, including 2,218 deaths.

“There has been no indication of any downturn in the epidemic in the three countries that have widespread and intense transmission,” it said, referring to Guinea, Liberia and Sierra Leone.

The scientists who produced the models cautioned that their dire predictions were based on the virus’s current uncontrolled spread and said the picture could improve if public health efforts started to work. Because conditions could change, for better or for worse, the researchers also warned that their forecasts became shakier the farther into the future they went.Continue reading the main storyPredicting Ebola’s Future Toll

Assuming current infection rates continue, a new model estimates there could be 20,000 Ebola cases by mid-October. The model’s estimate would nearly triple under deteriorating conditions and an increasing infection rate.

If conditions deteriorate

60 thousand

50

40

Future

cases

30

20

Cases and deaths

through Aug. 31

10

Deaths

Aug. 1

Sept. 1

Oct. 1

At current infection rates

20

10

Aug. 1

Sept. 1

Oct. 1

If conditions improve

10

Aug. 1

Sept. 1

Oct. 1Source: The Earth Institute, Columbia University

By The New York TimesContinue reading the main story Continue reading the main storyContinue reading the main story

Dr. Lewis, the Virginia Tech epidemiologist, said that a group of scientists collaborating on Ebola modeling as part of an N.I.H.-sponsored project called Midas, short for Models of Infectious Disease Agent Study, had come to a consensus on the projected 12- to 18-month duration and very high case count.

Another Midas participant, Jeffrey L. Shaman, an associate professor of environmental health sciences at the Columbia University Mailman School of Public Health, agreed.

Lone Simonsen, a research professor of global health at George Washington University who was not involved in the modeling, said the W.H.O. estimates seemed conservative and the higher projections more reasonable.

“The final death toll may be far higher than any of those estimates unless an effective vaccine or therapy becomes available on a large scale or many more hospital beds are supplied,” she said in an email.Continue reading the main story VideoPlay Video|3:47Dying of Ebola at the Hospital DoorDying of Ebola at the Hospital Door

Monrovia, the Liberian capital, is facing a widespread Ebola epidemic, and as the number of infected grows faster than hospital capacity, some patients wait outside near death.Video Credit By Ben C. Solomon on Publish Date September 11, 2014.Continue reading the main storyRecent CommentsWhaleRider1 hour ago

If we do nothing, and a messy civil war in West Africa breaks out, then humanity will begin to lose our most valuable asset in this battle,...Diane5 hours ago

Lots of people in these countries DO NOT WANT to be helped. They accuse health care workers of spreading/giving them the disease, don't...Steve Fankuchen6 hours ago

Perhaps this tragic epidemic will instill a bit of humility in people, as they (hopefully) ponder unintended consequences of the Green...

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Dr. Vespignani said that the W.H.O. figures would be reasonable if there were an effective campaign to stop the epidemic now, but that there is not.

The modeling estimates are based on the observed growth rate of cases and on factors like how many people each patient infects. The researchers use the past data to make projections. They can test their methods by, for instance, taking the figures from June, plugging them into the model to predict the number of cases in July, and then comparing the results with what actually happened in July.

Dr. Shaman’s research team created a model that estimated the number of cases through Oct. 12, with different predictions based on whether control of the epidemic stays about the same, improves or gets worse. If control stays the same, according to the model, the case count by Oct. 12 will be 18,406. If control improves, it will be 7,861. If control worsens, it will soar to 54,895.

Before this epidemic, the largest Ebola outbreak was in Uganda from 2000 to 2001, and it involved only 425 cases. Scientists say the current epidemic surged out of control because it began near the borders of three countries where people traveled a lot, and they carried the disease to densely populated city slums. In addition, the weak health systems in these poor countries were not equipped to handle the disease, and much of the international response has been slow and disorganized.

But questions have also been raised about whether there could be something different about this strain of Ebola that makes it more contagious than previous ones.

Researchers are doubtful, but Thomas W. Geisbert, an Ebola expert at the University of Texas Medical Branch in Galveston, said it was important to keep an open mind about the possibility. During vaccine tests expected to start next month in monkeys, he said, he and his colleagues will monitor infected animals to see if they develop unusually high virus levels early in the disease that might amplify its infectiousness.

Some scientists have also suggested that as the outbreak continues and the virus spreads from person to person, it will have more opportunities to mutate and perhaps become even more dangerous or contagious. But Stuart T. Nichol, chief of the C.D.C.’s Viral Special Pathogens Branch, said that so far, researchers monitoring the mutations had seen no such changes.

The US is woefully unprepared for receiving Ebola patients on routine flights from Africa. All of NY city hospitals are preparing for such cases, but the readiness is not great. Hospitals and emergency departments are not equipped for handling of such patients. I can imagine the panic that will occur, if a case is diagnosed at any of the city hospitals. The hospital might even empty!..causing huge financial losses...and if the virus becomes airborne...the panic will be complete. We also have our southern border to think off...what with the declaration of war by Obummer.

WASHINGTON—President Barack Obama plans to dramatically boost the U.S. effort to mitigate the Ebola outbreak in West Africa, including greater involvement of the U.S. military, people familiar with the proposal said.

Mr. Obama is expected to detail the plan during a visit Tuesday to the Centers for Disease Control and Prevention in Atlanta, these people said. Among the possible moves: sending additional portable hospitals, doctors and health-care experts, providing medical supplies and conducting training for health workers in Liberia and other countries.

Mr. Obama also is expected to urge Congress to approve the request he made last week for an additional $88 million to fund his proposal.

"There's a lot that we've been putting toward this, but it is not sufficient," Lisa Monaco, Mr. Obama's counterterrorism adviser, said in an interview Sunday. "So the president has directed a more scaled-up response and that's what you're going to hear more about on Tuesday."

The strategy has four components: control the outbreak at its source in West Africa; build competence in the region's public-health system, particularly in Liberia; bolster the capacity of local officials through enhanced training for health-care providers; and increase support from international organizations, such as the United Nations and the World Health Organization.

Mr. Obama plans to use a gathering of world leaders at the United Nations next week to seek commitments of funds, materials and health workers for a more robust international response.

The Ebola outbreak has infected at least 4,784 people as of Sept. 12, with 2,400 of them dying—a jump from 3,707 cases and 1,848 deaths as of Aug. 31. The true toll probably is much higher, the WHO says.

The Obama administration has grown increasingly concerned in the last two weeks, as infectious-disease and public-health experts warned that the global response is inadequate to subdue an epidemic that has spiraled out of control, and that it threatens the U.S. and other countries, not just West Africa.

Mr. Obama ordered a bolder U.S. effort about two weeks ago after CDC Director Tom Frieden briefed the White House on his findings from a trip to West Africa, senior administration officials said. Dr. Frieden said publicly on Sept. 2 that he saw dozens of patients lying on the ground in an Ebola treatment center because there weren't enough beds. "I could not possibly overstate the need for an urgent response," he said.

Mr. Obama's plan is a reaction to concern that the epidemic could significantly grow in West Africa, particularly in urban areas. Administration officials stress that the chances of an outbreak in the U.S. are low.

One rising concern among officials is the possibility that the virus could mutate in a way that would make it more dangerous.

The more the virus spreads from one human to another, the more opportunities it has to mutate, virologists say. While not all scientists agree that significant mutations that would change the way the virus is transmitted are likely, one recent study of virus samples over three weeks in Sierra Leone found many mutations.

While an administration official said a dangerous mutation of the virus is unlikely at this stage, "that is a concern that is motivating us to, and the international community more broadly, to get involved even more so now to bring this under control."

The CDC has at least 105 staff in West Africa—one of the largest deployments in CDC history—tracking down people who have been exposed to Ebola, conducting education campaigns, and other tasks. The government has spent more than $100 million on the outbreak since March, and recently committed an additional $75 million in funding, according to a U.S. Agency for International Development official. The money is used to deploy staff and deliver supplies, such as chlorine and water, as well as hospital beds.

The U.S. military has sent eight service members to the region, including doctors, a logistician and medical specialists. It also said it would send a 25-bed portable hospital unit to Liberia to help care for health workers, but it isn't planning to staff it. Many public-health and infectious disease experts have called for a greater U.S. military role, which is highly valued in humanitarian crises for its ability to command and control large operations, as well as its logistics expertise.

U.S. defense officials have ruled out sending hospital ships or the big-deck amphibious ships that frequently respond to humanitarian disasters. One official said if the virus got aboard one of those ships, it could quickly spread and would be difficult to stamp out.

These experts say that is what is needed in West Africa, because the governments of the three most affected countries—Liberia, Sierra Leone and Guinea —have been overwhelmed and their health-care systems have all but crumbled. The crisis also has become too large for aid organizations and health ministries to handle alone, they say. The current response, involving several local and international agencies and organizations, also lacks coordination.

The military could be used to direct supplies, set up tent hospitals, and tap the masses of medical personnel that are needed globally to get the sick into isolation and treatment, so they stop spreading the disease to others and improve their chances of recovery. Now, there are so few hospital beds that many are having to suffer through the disease at home, where they risk spreading it to loved ones.

And while hundreds of millions of dollars in aid have recently been pledged, under current circumstances it won't arrive in West Africa for weeks - by which time thousands more will be infected and dead.

Mr. Obama hopes to begin to turn the situation around with the rollout of his new strategy, administration officials said.

"We think these measures, this enhanced response, will help us bring this under control," an administration official said Sunday. "The military has unique capabilities in terms of logistical capacities, in terms of manpower, in terms of operating in austere environments."

The administration faces formidable challenges in carrying out any response plan. Not only is the virus now spreading fast, but health workers and epidemiologists have been physically attacked or run out of villages by angry or frightened locals. Some locals argue that Ebola is a bioweapon seeded by the West.

Joanne Liu, international president of Doctors Without Borders, called earlier this month for governments to send in their militaries. The aid organization has led treatment efforts since the beginning of the Ebola outbreak and has been warning for months that a bigger response is needed.

"Without this deployment, we will never get the epidemic under control," she said.

Yet another set of ominous projections about the Ebola epidemic in West Africa was released Tuesday, in a report from the Centers for Disease Control and Prevention that gave worst- and best-case estimates for Liberia and Sierra Leone based on computer modeling.

In the worst-case scenario, Liberia and Sierra Leone could have 21,000 cases of Ebola by Sept. 30 and 1.4 million cases by Jan. 20 if the disease keeps following its current trajectory, without effective methods to contain it. These figures take into account the fact that many cases go undetected, and estimate that there are actually 2.5 times as many as reported.

The report does not include figures for Guinea because case counts there have gone up and down in ways that cannot be reliably modeled.

In the best-case model — which assumes that the dead are buried safely and that 70 percent of patients are treated in settings that reduce the risk of transmission — the epidemic in both countries would be “almost ended” by Jan. 20, the report said. It showed the proportion of patients now in such settings as about 18 percent in Liberia and 40 percent in Sierra Leone.

That depends if it is "helped" along by means other than nature and people's will (or lack thereof), to control the flow of people entering and exiting countries. Even then, with all of the ill will in place these days, regardless of side, Ebola will run its course. It matters not. Enjoy the moment.

Logged

Do not fear going anywhere, nor doing anything. You will die where you are supposed to.

A nurse from one of the best health care systems in the world has contracted Ebola. The nurse cared for Thomas Eric Duncan, the man who traveled to Dallas from Liberia with the disease, and checked herself into her hospital's emergency room Oct. 12. This story challenges the Obama administration's narrative. In a September video message, Barack Obama told the people of Liberia it was safe enough to sit on the bus next to a person infected with the disease and still not contract Ebola. Cue the CDC, which issued a travel warning for the country, telling travelers to "avoid unnecessary travel." Now, doctors are saying it may be easier to contract the disease than previously assumed. Dr. Dennis Maki, an infectious diseases specialist at the University of Wisconsin-Madison, said, "Some of the garb the health worker takes off might brush against a surface and contaminate it. New data suggest that even tiny droplets of a patient's body fluids can contain the virus." The 3,000 American soldiers fighting Ebola in Liberia are in greater danger than Obama lets on.

The second half of 2014 saw the mainstream media focused on the West African Ebola outbreak and the potential for a widespread epidemic. But the turn of the calendar year has arrived with much more optimistic news for world health. An article published Wednesday in the scientific journal Nature reported the discovery of a new antibiotic. Representing what could very well be a paradigm shift, the paper chronicles two very important developments. The first is that this new antibiotic targets the bacterial cell in a way that prevents the easy development of resistance.

Teixobactin, the new antibiotic discussed in the article that works by targeting lipids that are essential to forming the cell wall, did not exhibit any antibacterial resistance when tested against bacteria mutated in the lab. The second development is perhaps even more groundbreaking. The researchers developed a new methodology to grow and isolate potential antibiotic targets. Up to this point, only a fraction of possible compounds could be cultivated in the lab, limiting researchers' ability to test new targets for activity against bacteria. This new method opens the door to a whole new world of possibilities.Dangers of Drug-Resistant Bacteria

These developments are a huge breakthrough for biology and medicine, but what does this mean for us as a geopolitical forecasting firm? Ebola showed us that just because a disease is covered in the news does not mean that it has a global or immediately obvious geopolitical impact. However, the potential for economic disruption from epidemics and endemic diseases, through lower production and increased expenditures because of treatment or trade restrictions, remains a possibility that would have geopolitical implications. Malaria, for instance, hinders the economic growth of developing countries looking to take advantage of low-end manufacturing opportunities as China's economy shifts. And while this new drug will not have an impact on the malaria epidemic, it could stop another in its tracks.

What is a Geopolitical Diary? George Friedman Explains.

Drug-resistant bacterial infections are a growing problem, one that until Wednesday did not have a good solution. Many antibacterial agents utilize the same chemical scaffolds or backbone, some of which have been around since the 1940s. Bacteria can and do easily mutate to adapt, and the overuse of antibiotics has contributed to the development of antibacterial-resistant strains of a number of diseases. Hospitals are seeing a rising number of MRSA (methicillin-resistant Staphylococcus aureus) cases, and drug-resistant tuberculosis is spreading throughout the globe. The high cost of treating drug-resistant tuberculosis, especially prevalent in Russia, Central Asia and Eastern Europe, put increased pressure on already struggling economies. The situation had reached a point to where speculation as to what a post-antibiotic society would look like was not completely unwarranted — and some of the scarier scenarios looked much like a pre-antibiotic society.

With little incentive for pharmaceutical companies to invest in expensive drug development, in part because of the development of resistance inherent in many classes of antibiotics, there had been little development or advancement in the field in decades, and resistance continued to rise. Teixobactin or another yet-to-be-discovered molecule could change that. Teixobactin attacks a specific family of bacteria — gram-positive, which includes the bacteria that causes both strep and staph infections — in a way that is not prone to the development of resistance. Resistance is less likely because of where the drug is active. Whereas some other antibiotics target proteins, teixobactin is believed to target lipids. The formation of proteins lends itself more easily to mutation than the synthesis of lipids. In initial tests, teixobactin showed efficacy in fighting drug-resistant tuberculosis.Exciting, but Not Immediate

Teixobactin is not a panacea. It does not work on gram-negative bacteria, a family that includes the bacterium that causes cholera. That is where the second and perhaps more important finding of the paper comes into play. The biological and medical communities now have a method to access a wide array of possible drugs that previously could not be studied. To put into perspective the staggering number of new possibilities, previously, only 1 percent of microbial targets could be cultured or grown in a lab, which is required to test for antibacterial activity. This new technique, which utilizes special equipment — a device called the iChip, which enables numerous bacteria to be grown and tested in their natural environments, such as soil, instead of using traditional laboratory methods — opens the door to the other 99 percent.

However, while incredibly exciting, this discovery does not necessarily have immediate geopolitical implications. It will not necessarily make drugs cheaper or more readily accessible to developing nations. It will also take several years to develop teixobactin and many more to discover other new drugs. What it really gives is an insurance policy of sorts. Disease outbreaks are hard to predict and rarely have global geopolitical impacts, but when they do, there is the potential for those implications to be staggering. The fear remains that an outbreak on the scale of the Spanish flu pandemic of 1918 could occur, and in a world that has become far more globalized in the past 100 years, the effects would reverberate through the world much more quickly. Widespread infections, decreased productivity, trade restrictions and border closures could all have economic ramifications that would matter at the geopolitical level.

And while this new discovery does not protect against viruses or parasitic diseases, it does provide a new set of weapons against bacterial infections. The "zombie apocalypse" may still come, but this recent technological advancement makes it far less likely to be in the form of drug-resistant bacteria.

Scientists have engineered a new molecule they say can block infection with the virus that causes AIDS, a discovery that could lead potentially to a new therapy for patients as well as an alternative to a vaccine.

Researchers have been trying for three decades to develop an effective vaccine against the human immunodeficiency virus, which causes AIDS. They are also searching for a way to flush HIV out of the bodies of the infected, to cure them. But the ever-evolving virus has eluded them thus far.

Now, a team from the Scripps Research Institute and other institutions says it has identified a new way to prevent HIV from infecting cells, using an approach that resembles gene therapy or transfer.

HIV normally invades the body through two cellular receptors. The new protein the scientists created blocks the points where the virus binds to both receptors, leaving no point of entry.

Because it attaches to both receptors rather than just one, the protein, called eCD4-IG, blocks more HIV strains than any of several powerful antibodies that have been shown to disable the virus, the researchers said. The research was published online Wednesday by the journal Nature.

“It is absolutely 100% effective,” said Michael Farzan, a professor of infectious diseases at the Scripps Research Institute in Jupiter, Fla. and lead author of the study. “There is no question that it is by far the broadest entry inhibitor out there.”

The approach has been tested only on four rhesus monkeys, and has yet to be tried on humans.

But the researchers and other scientists not involved with the work said it shows promise and should move into human testing quickly. An estimated 35 million people are infected with HIV, but only 13.6 million receive drug treatment to keep the virus from spreading.

“It’s very clever and very powerful,” said Nancy Haigwood, an HIV researcher at Oregon Health & Science University, who wasn’t involved in the study. “This is going to be much better than any vaccine on the horizon,” said Dr. Haigwood, who also wrote about its potential as a vaccine alternative in a commentary in Nature.

The scientists created the protein by fusing together elements of both cellular receptors to which HIV binds. They then injected genetic material from the protein into a muscle of the rhesus monkeys, stimulating production of the new molecule.

They infected the monkeys with multiple hybrid versions of HIV, administering up to four times the amount of virus it took to infect a control group. The protein protected the monkeys for 40 weeks.

Dr. Farzan said the monkeys were uninfected even when given 16 times the amount of virus that it took to infect the control group in experiments conducted after the study was completed.

He said he hoped human trials could begin within a year, after more testing in animals that is already under way. The first step, he said, would be to gauge the ability of the molecule to keep virus levels in HIV-positive people in check.

“We believe our goal now is to show it can work therapeutically,” he said.

The next step would be to test its efficacy as a vaccine, in people who don’t have the virus but are at high risk of infection, Dr. Farzan said.

The work builds on a 2009 study that proposed using gene transfer as an alternative to a traditional vaccine for HIV.

Philip Johnson, a professor at the University of Pennsylvania who led that earlier work, said the new research offers promise for that concept. “It appears to be an extraordinarily potent molecule,” he said. “It’s further validating of the idea that we should be thinking in alternate terms about how to attack HIV vaccines.”

He said it should be tested in humans right away. “To me the nonhuman primate data are outstanding,” he said.

Well wait a second. It was Obama's policies that allowed the Ebola virus into the US that led to her infection. This was the same girl shown hugging Obamster. She should be blaming him. Not the hospital.

By ABBY GOODNOUGHMAY 5, 2015PhotoSherry McNeely, right, a nurse, testing for H.I.V. on Monday in a mobile testing unit in Austin, Ind. Credit Aaron P. Bernstein for The New York Times

AUSTIN, Ind. — She became addicted to painkillers over a decade ago, when a car wreck left her with a broken back and doctors prescribed OxyContin during her recovery. Then came a new prescription opiate, Opana, easily obtained on the street and more potent when crushed, dissolved in water and injected. She did just that, many times a day, sometimes sharing needles with other addicts.

Last month, the thin, 45-year-old woman learned the unforgiving consequences. She tested positive for H.I.V., one of nearly 150 cases in this socially conservative, largely rural region just north of the Kentucky border. Now a life long hobbled by addiction is, like so many others here, consumed by fear.

She is afraid to start antiretroviral therapy because she does not want to be spotted entering the clinic on Main Street, she says, and afraid to learn her prognosis after hearing a rumor — false, it turns out — that someone else with the virus was given six months to live. Other drug users have refused to be tested at all.

“I thought it was just a homosexual disease,” the woman said one recent evening, twisting a tissue in her manicured hands as tears filled her eyes. She asked that her name not be published out of concerns about being stigmatized. “I didn’t ever think it would be in my small hometown.”

The crisis would test even a large metropolis; Austin, population 4,200, is overwhelmed despite help from the Centers for Disease Control and Prevention, the state and nonprofit groups like the AIDS Healthcare Foundation. H.I.V. had been all but unknown here, and misinformation is rife. Attempts to halt the outbreak have been hindered by strong but misguided local beliefs about how to address it, according to people involved in the response.

Gov. Mike Pence reluctantly authorized a needle exchange program last month, but local officials are not running it according to best practices, outside experts say. Austin residents still must wait for addiction treatment, even though they have been given priority. And getting those who are H.I.V.-positive on medication, and making sure they adhere to the protocol, has been difficult.

Officials here say the need for education is urgent and deep; even local health workers are learning as they go. Brittany Combs, the public health nurse for Scott County, said she was stunned to discover from talking to addicts that many were using the same needle up to 300 times, until it broke off in their arms. Some were in the habit of using nail polish to mark syringes as their own, but with needles scarce and houses full of people frequently shooting up together, efforts to avoid sharing often failed.

Ms. Combs also learned that many addicts were uncomfortable visiting a needle distribution center that opened April 4 on the outskirts of town. So she started taking needles directly to users in their neighborhoods.

At the same time, H.I.V. specialists from Indianapolis — who have evaluated about 50 people with the virus here so far and started about 20 of them on antiretroviral drugs — are fighting a barrage of misinformation about the virus in Scott County, where almost all residents are white, few go to college and one in five live in poverty, according to the census.

“There are still a significant proportion of people in Austin who have biases about H.I.V. and are contributing to the stigma and subsequent fear,” said Dr. Diane Janowicz, an infectious disease specialist at Indiana University, who is treating H.I.V. patients here. “I have to reassure them: If your grandkid wants a sip of your drink, you can share it. It’s O.K. to eat at the same table. You can use the same bathroom.”

Many whose H.I.V. has been newly diagnosed here have strikingly high amounts of it in their blood, Dr. Janowicz said, and in one patient the H.I.V. has progressed to AIDS. Nonetheless, she said, “if they take their medicine for H.I.V., this is a chronic disease, not something they have to die from.”

Another complication is that the needle exchange has faced strong local resistance. Mr. Pence, a Republican, generally opposes such programs, saying they perpetuate drug use. Many residents here feel the same.

“If you would have asked me last year if I was for a needle exchange program, I would have said you’re nuts,” Ms. Combs said. “I thought, just like a lot of people do, that it’s enabling — that you’re just giving needles out and assisting them in their drug habit. But then I did the research on it, and there’s 28 years of research to prove that it actually works.”

But researchers say Scott County’s hastily created exchange has several features that could sharply curb its effectiveness. To get clean needles, drug users have to register, using their birth date and a few letters from their name to create an identification number that goes on a laminated card. The police are arresting anyone found with needles but no card, saying it will prod more people to participate.

Shortly after the needle exchange began, sheriff’s deputies visited a house in Austin and found a man who had joined the program and a woman who had not. They did not arrest the man, Sheriff Dan McClain said, although they confiscated a number of clean needles he had received from a volunteer group that was not part of the official program. But they did arrest the woman, who had “a freshly used needle lying next to her” in a bed spattered with blood, Sheriff McClain said.

“If they’ve got one needle and they’re not in the program, they’re going to jail,” Sheriff McClain said.

Dr. Don Des Jarlais, the director of research for the chemical dependency institute at Mount Sinai Beth Israel hospital in New York, said the most successful needle exchange programs let participants pass out syringes to peers who remain in the shadows instead of requiring everyone to sign up. Arresting drug users who are not officially enrolled in the program “makes it hard to build trust,” Dr. Des Jarlais said, adding, “You’re not going to be able to get enough syringes out to really stop the epidemic if you have those types of restrictions.”

Local supporters of the needle exchange say a limited program is better than none, and believe that improvements will come with time. Last week, the state legislature sent a bill to Mr. Pence that would allow communities to create needle exchange programs for up to a year if they are experiencing an epidemic of H.I.V. or hepatitis C because of intravenous drug use. Mr. Pence said he would sign the measure, noting in a statement that it would allow only “limited and accountable” needle exchange programs, and only “where public health emergencies warrant such action.”

For now, the program here is giving out a maximum of 140 clean needles per user per week to whoever goes to the outreach center or accepts them from the roaming minivan. Ms. Combs said some people told her they injected as often as 15 times a day, and the exchange is erring on the side of providing slightly more than people need. She has passed out needles at a house where the owner, an older woman known as Momma, sits on the porch while a steady stream of visitors comes to shoot up inside. She has knocked on the door of a trailer where, she said, “multiple family members live and the daughters all prostitute themselves out and everyone is doing drugs.” One recent afternoon, on a street fragrant with lilacs, a young woman on a bicycle declined Ms. Combs’s offer of clean needles, saying she already had some — and H.I.V.

“I know I need the medicine to slow it down,” she murmured.

At a run-down house with a wheelchair on the porch, Tiffany Prater, 27, walked out to greet the van, saying, “The needles ain’t lasting me long enough.” She beckoned two men out of the house to get some, too.

The van moved on, stopping as someone yelled from a white house with a broad lawn. A woman in a pink tank top emerged, saying a neighbor had taken some of her clean needles and her daughter’s, too.

The daughter could not come out of the house — she had just injected and “can’t get up from the kitchen table,” the mother said. Ms. Combs gave the woman needles for her and her daughter.

“Spread the word that this white vehicle is a friendly mobile,” she said.

As of Tuesday, the exchange had distributed 9,491 needles to 223 people, including many repeat customers. About 8,300 needles had been returned to the exchange, but not all of them came from the exchange program.

Some participants say they are happy to have clean needles but would be happier in treatment. While some intravenous drug users from Austin have recently gone into treatment at a residential center in Jeffersonville, about 30 miles away, others are still waiting for a bed.

A 23-year-old user with H.I.V. said he had gone to the community outreach center to get clean needles and seek addiction treatment, but was put on a waiting list. Two weeks later, he is still waiting.

Opana remains easy to get, he added, a quarter of a pill selling for $40 — enough of a dose to ease his withdrawal symptoms and enable him to get out of bed.

One unexpected benefit of the H.I.V. outbreak, according to the woman who tested positive and fears starting treatment, is that the men who used to stream into town daily, seeking young female addicts who would prostitute themselves in exchange for drug money, have all but disappeared.

“It took H.I.V. to change our town,” she said. “Those of us who are affected are devastated, but I’m glad H.I.V. is here.”

@this time this is the opinion. I wonder if the seasons being opposite in S America to N America helps reduce the chance of spread here. I imagine though that this will be a perineal problem and will be interesting to see if much of it is here in the spring:

25 % in one year is unbelievable. Guillain Barre is also a concern as well as pregnancy.

No stopping it.

I wonder if once one has it are they later immune. Will it mutate?

Ebola:

4 NEW deaths of Ebola in Guinea. I was part of a response team in NJ for Ebola and we just finished the program screening passengers coming to the US as epidemic seemed over - for this time around.

We still do not know the vector - yes it appears to be from exposure to "bush" meat like monkeys or bats. But how does it get into the bush meat? No one knows. Insects maybe the true carriers as per some of the very brave researchers who go out in the field and study these things. Often the limits to researching this is money.

CDC does incredible work. Their facilities are gigantic in Atlanta. And many of the people we met are brilliant. I only wish they would not get into issues that every bit as political as oriented to disease.

What is "disease" about gun ownership. What is disease about sea pollution? What is disease about trans fat? etc.